Hyperthyroidism Archives - ThyForLife

Hypothyroidism vs. Hyperthyroidism: What is the difference?

Daniel Amoah — Tue, 02 Jul 2024 03:51:12 +0000

As the saying goes, “We don’t appreciate what we have until it’s gone.” This certainly holds true for the thyroid gland, the small, butterfly-shaped gland nestled in your neck. Even though it’s such a vital organ, we barely notice it or even think about it. That is, of course, when it’s functioning properly.

It’s therefore no surprise that thyroid dysfunction is what usually makes it clear how important this organ is. This is mainly because a dysfunctional thyroid causes a range of symptoms that can significantly impact your everyday life.

The state of the thyroid, in terms of function, can be broadly categorized under hypothyroidism (underactive thyroid), hyperthyroidism (overactive thyroid), and euthyroidism (normal functioning thyroid). The first two are two main types of thyroid dysfunction that are opposite each other. To know which thyroid condition you have, a thyroid function test (sometimes in combination with other tests) is necessary. A thyroid function test is a combination of blood tests that measure levels of thyroid-stimulating hormone (TSH) and the thyroid hormones in your blood in order to make a diagnosis or monitor your response to treatment.

In this article, we will discuss these two thyroid conditions, and also compare them to euthyroidism.

Hypothyroidism (Underactive Thyroid)

What is hypothyroidism and what are the causes?

Hypothyroidism, often referred to as an underactive thyroid, occurs when the thyroid gland does not produce enough thyroid hormones. These hormones, thyroxine (T4) and triiodothyronine (T3), are vital for regulating the body’s metabolic rate. In iodine-sufficient geographical regions, the most common cause is Hashimoto’s thyroiditis, an autoimmune disease. From a global perspective, however, the most common cause is iodine deficiency. Other possible causes of this condition include radiation treatment or exposure and certain medications.

How common is hypothyroidism?

Hypothyroidism is one of the most common endocrine disorders worldwide. Its prevalence varies by age, sex, and geographical location, largely due to differences in iodine intake. It is estimated that hypothyroidism affects about 5% of people above the age of 12 in the United States, while subclinical hypothyroidism, a milder form of the disease, affects at least an additional 5%. Women are more likely to develop hypothyroidism than men, and the risk increases with age.

What are the symptoms?

Symptoms of hypothyroidism develop slowly and can be vague. They include fatigue, weight gain, cold intolerance, constipation, dry skin, hair loss, slow heart rate, muscle weakness, irregular periods, and depression. Because these symptoms can be attributed to other conditions, hypothyroidism can sometimes be overlooked.

How is hypothyroidism treated?

Treatment for hypothyroidism involves a lifelong daily dose of synthetic thyroid hormone levothyroxine. This oral medication restores adequate hormone levels, and as a result reverses the signs and symptoms of hypothyroidism. Taking this medication comes with guidelines that ensure that you get the best possible treatment outcomes. While a majority of patients take levothyroxine, there are some who are prescribed some alternative medication such as the T3+T4 combination therapy.

In any case, periodic blood tests are performed to assess the effectiveness of the treatment. Based on your lab results, your doctor may decide to adjust your dosage, if necessary.

Hyperthyroidism (Overactive Thyroid)

What is hyperthyroidism and what are the causes?

Hyperthyroidism occurs when the thyroid gland produces too much thyroid hormone. This overactivity can accelerate the body’s metabolism, leading to rapid weight loss and a bunch of other symptoms. The most common cause of hyperthyroidism is the autoimmune disorder known as Graves’ disease. Other causes include thyroid nodules, and excessive iodine intake.

How common is hyperthyroidism?

Hyperthyroidism is less common than hypothyroidism. It affects about 1% of Americans, with a higher prevalence in women than in men. Graves’ disease in particular is responsible for about 60-80% of cases of hyperthyroidism. Hyperthyroidism can occur at any age but is most commonly diagnosed in people between the ages of 20 and 50.

What are the symptoms?

The symptoms of this condition include unexpected weight loss, anxiety, irritability, fast heart rate, hand tremors, frequent bowel movements or diarrhea, heat intolerance, and having trouble sleeping. Some people with hyperthyroidism may also experience swelling in the neck due to an enlarged thyroid gland (goiter) or an eye condition known as thyroid eye disease (TED).

How is hyperthyroidism treated?

The treatment of hyperthyroidism aims to reduce thyroid hormone production and may involve radioactive iodine therapy, anti-thyroid medications, or surgery. Your doctor may also prescribe beta-blockers, such as propranolol or nadolol. The purpose of these drugs is to control some of the uncomfortable symptoms associated with high thyroid levels, such as rapid heart rate and anxiety.

Key takeaways

Despite their similar names, hypothyroidism and hyperthyroidism have different causes, symptoms, and treatments.
Hypothyroidism is characterized by an underactive thyroid and as a result, low thyroid hormone levels. Hyperthyroidism, on the contrary, is characterized by an overactive thyroid and therefore, high levels of thyroid hormones.
Both conditions can cause fatigue and changes in weight, but the direction of the change is a key difference. Hypothyroidism often leads to weight gain and feeling cold, while hyperthyroidism can cause weight loss and heat intolerance.
If you’re experiencing symptoms that might be related to your thyroid, seek immediate medical attention. An early diagnosis and effective treatment can help you manage your condition and get back to feeling your best.
Hypothyroidism is usually treated with synthetic thyroid hormone medication, while hyperthyroidism treatment may involve medication, radioactive iodine treatment, or surgery to reduce hormone production.
If you’ve been diagnosed with either condition, be sure to follow your treatment plan closely and report any new symptoms to your doctor.

The post Hypothyroidism vs. Hyperthyroidism: What is the difference? appeared first on ThyForLife.

Hashimoto’s Thyroiditis vs. Graves’ Disease: A comparison of the two main autoimmune thyroid disorders

Daniel Amoah — Mon, 24 Jun 2024 19:10:36 +0000

The thyroid gland, a butterfly-shaped organ in your neck, plays a big role in regulating your body’s energy metabolism through the release of thyroid hormones, thyroxine (T4) and triiodothyronine (T3). However, when the immune system, your body’s natural defense system against foreign substances in the body, mistakenly targets this gland, it can lead to a condition generally known as autoimmune thyroid disease (AITD).

AITD presents clinically in two main forms—Hashimoto’s thyroiditis and Graves’ disease. Hashimoto’s thyroiditis is named after Dr. Hakaru Hashimoto, the Japanese physician who first described the condition in 1912. Grave’s disease, on the other hand, is named after the Irish doctor Robert James Graves, who first described the condition in 1835. Although a similar description was independently made by the German physician Karl Adolph von Basedow in 1840, the condition became widely known as Graves’ disease mainly in English-speaking countries, while in other parts of the world, such as mainland Europe (especially Germany) and Japan, it is often referred to as Basedow’s disease.

Despite their similarities in being thyroid-related autoimmune diseases, the impacts of Hashimoto’s thyroiditis and Graves’ disease on the body, their symptoms, and their treatments differ significantly. In this article, we will highlight the differences, and in some cases, similarities between these two diseases.

What is Hashimoto’s thyroiditis?

Hashimoto’s thyroiditis, also known as Hashimoto’s disease or chronic lymphocytic thyroiditis, is the leading cause of hypothyroidism (underactive thyroid) in regions without iodine deficiency. It occurs when the immune system attacks the thyroid gland, causing chronic inflammation of the thyroid (a condition known as thyroiditis), gradually destroying the thyroid tissue and reducing the gland’s ability to produce hormones. This disease is more common in women than in men, and although the exact underlying cause of the autoimmune attack on the thyroid remains unknown, scientists believe genetics and environmental factors are involved.

Antibodies involved in Hashimoto’s thyroiditis

In people with Hashimoto’s disease, the immune system produces antibodies against thyroid peroxidase (TPO) and thyroglobulin (Tg). The main antibodies involved are:

Thyroid Peroxidase Antibodies (TPOAb): These are the most common antibodies found in Hashimoto’s thyroiditis. They target the enzyme thyroid peroxidase which is needed for making thyroid hormones T4 and T3.
Thyroglobulin Antibodies (TgAb): These antibodies target thyroglobulin, a protein involved in the storage of thyroid hormones.

The detection of these antibodies in the blood can help diagnose Hashimoto’s thyroiditis, even before symptoms become obvious.

Symptoms of Hashimoto’s thyroiditis

Fatigue and sluggishness
Increased sensitivity to cold
Constipation
Slowed heart rate
Pale, dry skin and hair loss
A puffy face
Weight gain
Muscle weakness, aches, and stiffness
Depression

What is Graves’ disease?

Graves’ disease is the opposite of Hashimoto’s in terms of thyroid function. It is the most common cause of hyperthyroidism (overactive thyroid). This disease occurs when the immune system produces antibodies that attach to the thyroid cells, stimulating them to produce excessive amounts of thyroid hormones. Like Hashimoto’s, Graves’ disease is more prevalent in women and can be influenced by genetic factors. Other risk factors identified by researchers are smoking and emotional stress.

Antibody involved in Graves’ disease

In people with Graves’ disease, the immune system produces a specific type of antibody known as the Thyroid-Stimulating Immunoglobulin (TSI). TSI mimics the action of the thyroid-stimulating hormone (TSH), which is normally produced by the pituitary gland to regulate thyroid activity. When TSI binds to the thyroid cells, it stimulates the gland to produce excessive amounts of thyroid hormones. TSI is a subset of a broader category of antibodies known as Thyrotropin Receptor Antibodies (TRAb), which include both stimulating and blocking antibodies.

TSI can also affect tissues in the eyes and skin, leading to the distinctive eye symptoms (Graves’ ophthalmopathy) and, in some cases, pretibial myxedema, which involves swelling and thickening of the skin on the shins.

Symptoms of Graves’ disease

Anxiety and irritability
Tremor in hands or fingers
Rapid or irregular heartbeat
Heat sensitivity and an excessive perspiration (sweating)
Weight loss, despite normal eating habits
Enlargement of the thyroid gland (goiter)
Change in menstrual cycles
Erectile dysfunction or reduced libido
Frequent bowel movements
Bulging eyes (also the main symptom of thyroid eye disease)

Diagnosis and Treatment

The diagnoses for both conditions involve a thorough clinical evaluation. Before you’re diagnosed, your doctor will order some blood tests to measure levels of thyroid hormones and thyroid-stimulating hormone (TSH), as well as the antibodies associated with each condition. Imaging tests, such as an ultrasound of the thyroid, may also be used to examine the structure and size of the gland. For Graves’ disease, a radioactive iodine uptake test can also be a helpful diagnostic tool. While your symptoms can be useful in the assessment of your condition, doctors do not solely rely on them to make a diagnosis because thyroid symptoms often resemble symptoms of many other conditions.

Treatment for Hashimoto’s thyroiditis

The primary treatment for Hashimoto’s thyroiditis is hormone replacement therapy with levothyroxine, a synthetic form of the thyroid hormone thyroxine (T4). This medication helps to normalize thyroid hormone levels and manage symptoms of hypothyroidism.

Treatment for Graves’ disease

Treatment options for Graves’ disease include anti-thyroid medications, radioactive iodine therapy, and surgery. These treatments aim to reduce thyroid hormone production or remove the thyroid gland, respectively. Beta-blockers might also be prescribed to manage some symptoms associated with hypothyroidism, such as anxiety, heat intolerance, tremors, and increased heart rate.

A summary of the comparison between Hashimoto’s thyroiditis and Graves’ disease

Here’s a table highlighting the key differences (and similarities) between Hashimoto’s disease and Graves’ disease:

Feature	Hashimoto’s Thyroiditis	Graves’ Disease
Type of Thyroid Dysfunction	Hypothyroidism (Underactive Thyroid)	Hyperthyroidism (Overactive Thyroid)
Primary Cause	Immune system attacks thyroid, reducing hormone production	Immune system stimulates excess thyroid hormone production
Antibodies	Thyroid Peroxidase Antibodies (TPOAb), Thyroglobulin Antibodies (TgAb)	Thyroid Stimulating Immunoglobulin (TSI)
Symptoms	Fatigue, weight gain, cold sensitivity, constipation, depression	Anxiety, weight loss, heat sensitivity, irritability, bulging eyes (in Graves’ ophthalmopathy)
Sex Prevalence	More common in women	More common in women
Diagnosis	Blood tests for TPOAb, TgAb, TSH, and thyroid hormones	Blood tests for TSI, TSH, and thyroid hormones; possibly ultrasound or radioactive iodine uptake test
Treatment	Hormone replacement therapy (Usually Levothyroxine)	Anti-thyroid medications, radioactive iodine therapy, surgery, beta-blockers (for symptom management)
Potential Complications	Heart problems, myxedema (severe hypothyroidism)	Heart problems, osteoporosis, Graves’ ophthalmopathy, thyrotoxic crisis (severe hyperthyroidism)

Key takeaways

In autoimmune diseases, the body’s immune system mistakenly targets and attacks normal cells. In the case of Hashimoto’s and Graves’ diseases, the immune system targets the thyroid gland.
While both Hashimoto’s and Graves’ diseases are autoimmune conditions that affect the thyroid gland, their overall impact on the body is opposite.
Hashimoto’s disease results in a decrease in thyroid hormone production, leading to hypothyroidism, while Graves’ disease increases hormone production, causing hyperthyroidism.
The presence of these thyroid autoantibodies can be detected through blood tests, which is necessary for the diagnosis of both Hashimoto’s and Graves’ diseases. For Hashimoto’s, TPOAb and TgAb levels are tested for, while for Graves’, measuring the levels of TSI is needed to make a diagnosis.
If you’re concerned about your thyroid function, talk to your doctor. With early diagnosis and treatment, you can manage your thyroid condition and live a full and healthy life.

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Thyroid Eye Disease: Symptoms, Treatment & Clinical Trial

Natalia Lumen — Fri, 17 Feb 2023 17:03:06 +0000

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What is Thyroid Eye Disease?

Thyroid eye disease (TED), also known as Graves’ ophthalmopathy and orbitopathy, is a rare autoimmune condition that occurs when the body’s immune system attacks the tissues around the eye, causing inflammation and damage to the tissues of the eye.

The tissues affected include the eye (extraocular) muscles, fatty tissues, and connective tissues. In rare cases, this disease can result in loss of vision.

The precise mechanisms underlying the cause of this disease are not well understood currently. People with family members with the disease or some other autoimmune disease may have a higher genetic predisposition to developing this disease than other people.

TED can occur in people with hypothyroidism (thyroid underactivity), hyperthyroidism (thyroid overactivity), or euthyroidism (normal functioning of the thyroid) but is more common among people with Graves’ disease or some other hyperthyroid condition. Hyperthyroidism makes up about 90% of cases of TED.

Prevalence is also higher among women than men. The average age for TED is 43 years for all patients; however, one could be diagnosed as early as 8 years old or as late as 88 years old.

The clinical course of this disease is in two main phases—the progressive inflammatory phase, which can last for months to a few years, and the post-inflammatory stable phase.

TED can also significantly have a negative impact on your quality of life, especially in emotional and social aspects. Fluctuating thyroid hormone levels, typical of TED, could make one irritable and have mood swings. TED’s effect on the appearance of one’s eyes and visage could lead to social isolation and feelings of anger or depression.

This article will mainly discuss:

Some symptoms of TED
How to properly manage the disease to prevent the exacerbation of symptoms
The available treatment options for treating the disease

What are the symptoms of TED?

The symptoms of TED vary from one patient to the other, especially in severity. Patients are likely to be treated for other eye conditions instead of TED due to some similarities among these conditions, which sometimes makes TED challenging to diagnose.

However, unlike conditions such as hay fever and allergies, TED could occur outside the regular season for hay fever and typically doesn’t involve itchy eyes, unlike allergies.

To confirm you actually have TED, consult your doctor immediately if you notice some of the following symptoms, especially if you’ve already been diagnosed with a thyroid condition.

Blurry or double vision
Gritty sensations in the eye
Watery eyes
Swelling of eyelids
Eyelid retraction
Bulging eyes
Dry eyes
Painful eye movements and pain behind the eyes
Difficulty closing the eyes
Light sensitivity
Misalignment of the eyes (strabismus)
Headaches associated with progressive swelling of the eyeballs

How can TED be appropriately managed?

If you’ve been diagnosed with TED, you will have to be looked after by an ophthalmologist and an endocrinologist. Including a psychologist in the treatment plan is ideal, as TED tends to cause cosmetic changes, which may negatively impact the patient’s emotional and overall psychological well-being.

There are also some precautions you would do well to take to avoid aggravating your symptoms or slowing your treatment. If you’re a smoker, you should quit smoking as it worsens TED.

Research studies have consistently linked cigarette smoking to the development and exacerbation of TED. Stress may also exacerbate the disease, so avoiding stress or stressful situations is essential.

Other lifestyle changes that help manage the disease include keeping your head higher than your body when sleeping in order to reduce the swelling of the eyes, wearing sunglasses, and taping your eyelids shut or using eye covers when sleeping to prevent further dryness of the eyes.

Radioactive iodine, a treatment for Graves’ disease or hyperthyroidism, has the propensity to worsen an active thyroid eye disease. This may be offset by supplementing this treatment with steroids under the recommendation of your healthcare provider.

What are the available treatment options?

While TED may be linked to some pre-existing thyroid condition, treating a thyroid disease does not result in the treatment of TED. However, conservative management options such as quitting smoking and maintaining normal thyroid hormone levels may help prevent symptoms from worsening. Treatment options include surgery, medications, or lifestyle changes.

The following are some effective treatment options for TED:

Teprotumumab: Clinical studies have shown that this biological infusion therapy effectively mitigates the symptoms of thyroid eye disease. In early 2020, teprotumumab-trbw (Tepezza®) became the first drug approved by the United States Food and Drug Administration (FDA) to treat adults with thyroid eye disease. It currently remains the only FDA-approved drug for TED treatment.

The drug works as a targeted inhibitor of the insulin-like growth factor-1 (IGF1-R), a protein that is instrumental in the development of the disease. This medication has proven to be effective in the abatement of typical TED symptoms and has improved the overall quality of life of affected individuals taking the drug.

Surgery: While treatment during the active phase of the disease is targeted at preserving sight and the integrity of the cornea, treatment within the second phase when the inflammation has resolved, typically involves the treatment of certain permanent changes, which would generally require surgery for rehabilitative therapeutic outcomes such as the correction of double vision or reduction in the retraction of the eyelids.

There are different surgical options suited for different conditions of the eye. Some of such surgical options are outlined as follows:

Orbital decompression surgery: This surgical procedure removes bone and soft tissue from behind the eye to create more space and to help return the eye to a normal position within its socket. This surgical option may also be employed in the active phase of TED for the relief of optic neuropathy and reduction in congestion and inflammation of the eye, effectively reducing the bulging of the eye. Orbital decompression surgery is typically performed in advance of eyelid surgery or eye muscle surgery, if necessary.
Eyelid surgery: Your doctors may recommend eyelid surgery to get your eyelids back into a normal position if they pull back too much. This surgical procedure helps improve the appearance and function of the eyelids. Since the tightened muscles in the eyelids make closing the eyelids difficult, leaving the cornea (front of the eye) exposed, eyelid surgery helps decrease corneal exposure and irritation.
Eye muscle surgery: This procedure is essential for correcting severe double vision by repositioning the affected muscles around the eyes farther back from their original positions on the eye. This surgical procedure may have to be performed more than once for optimal results.

Steroid medication: Loss of vision or double vision may be treated, for a limited period, with prednisone, a systemic corticosteroid (cortisone-like drug or steroid) that is capable of suppressing autoimmune inflammation. Treatment with prednisone for an extended period is likely to yield adverse side effects on the individual.

Orbital inflammation can be reduced with appropriate doses of oral prednisone or intravenous methylprednisolone. Treatment with prednisone also reduces swelling behind the eyes.

Lifestyle changes: Aside from quitting cigarette smoking, certain lifestyle changes could be effective in treating TED by easing some of the usual symptoms depending on the severity of the disease.

For instance, dark sunglasses could be used to manage light sensitivity to treat mild cases of TED. Over-the-counter eye drops (artificial tears), gels, and ointments can be used to treat dry or irritated eyes. Taking over-the-counter selenium supplements can also help mitigate TED symptoms.

Special prescription lenses known as prism prescription can correct double vision. Some people also opt for an eyepatch on one eye to manage their double vision.

Radiation: In some instances, radiation might be recommended as a treatment option for TED to reduce swelling in tissues around the eye, including muscle tissues. Radiation therapy may be recommended for patients who respond to prednisone to mitigate double vision and loss of vision in severe cases.

The downside to this treatment option is that it may be limited in its abatement of the symptoms of TED and may result in ocular dryness. It is also not advisable to be used more than twice in one’s lifetime as it has the propensity to result in tumors.

Clinical Trial Recruiting for Thyroid Eye Disease

If you’re interested in learning more and exploring possible clinical research options, we invite you to complete the questionnaire today to see if you qualify!

Key Takeaways

Thyroid eye disease (TED) is an autoimmune condition that causes inflammation and damage to the tissues of the eye. About 90% of people with TED are also hyperthyroid. The inflammatory and stable phases constitute the two phases of the course of this disease.
Some typical symptoms of TED include blurry or double vision, dry or watery eyes, retraction of eyelids, bulging eyes, and painful eye movements.
Besides medication, surgery and radiation therapy, some lifestyle changes can help effectively mitigate the symptoms of this disease.
Cigarette smokers are at a high risk of developing this condition. It is, therefore, imperative to quit smoking to prevent the worsening of your symptoms.
Although Graves’ disease and Graves’ ophthalmopathy (thyroid eye disease) are both autoimmune diseases, one is not directly caused by the other, so the treatment of one does not result in the treatment of the other.
Teprotumumab, an FDA-approved drug for treating adults with thyroid eye disease, works by blocking the protein IGF1-R and inhibiting its role in the development of TED. Prior to its approval in 2020 by the FDA, clinical studies showed it was effective in alleviating the symptoms of the disease.
A Thyroid Eye Disease clinical research opportunity is available to our community! If interested in learning more, complete this study eligibility questionnaire.

The post Thyroid Eye Disease: Symptoms, Treatment & Clinical Trial appeared first on ThyForLife.

Hyperthyroidism Archives - ThyForLife

Hypothyroidism vs. Hyperthyroidism: What is the difference?

Key takeaways

Hashimoto’s Thyroiditis vs. Graves’ Disease: A comparison of the two main autoimmune thyroid disorders

Diagnosis and Treatment

Treatment for Hashimoto’s thyroiditis

Treatment for Graves’ disease

A summary of the comparison between Hashimoto’s thyroiditis and Graves’ disease

Key takeaways

Thyroid Eye Disease: Symptoms, Treatment & Clinical Trial

Medically reviewed by

Clinical Trial Recruiting for Thyroid Eye Disease

What is Thyroid Eye Disease?

What are the symptoms of TED?

How can TED be appropriately managed?

What are the available treatment options?

Clinical Trial Recruiting for Thyroid Eye Disease

Key Takeaways